Little is known about alcohol use by persons with disabilities. Yet some persons with disabilities may be at risk for alcohol abuse, dependence or addiction. A pilot study examining pre- admission patterns of alcohol use by rehabilitation inpatients found that persons with spinal cord injuries may be at particular risk Medical and vocational rehabilitation outcome may be profoundly influenced by alcohol abuse; however, this relationship has yet to be established. This three-year, prospective project will study the relationship between alcohol use and rehabilitation outcome in a sample of 150 persons with recent injuries, Initial, 6-, 12-, 18- and 30-month evaluations are planned; to date, three-quarters of the initial evaluations are complete. While internal funds were made available to demonstrate the feasibility of this project; no further internal funds are available. Hence, this proposal requests funding to evaluate post-injury alcohol use, the rehabilitation outcome achieved by study participants, and the relationship between alcohol use and rehabilitation outcome. Instruments that produce quantifiable data will be used to assess demographic characteristics; medical history; depression; acceptance of disability; frequency, quantity and recency of alcohol abuse family history of alcohol abuse; and rehabilitation outcome. Frequency, discriminant, factor and path analyses will be used to analyze the data. Early identification of persons with spinal cord injuries who abuse or are addicted to alcohol, or who are at risk for abuse, should decrease the cost of rehabilitation and improve rehabilitation outcome. Since the annual medical cost for all persons with SCI is estimated at $1.9 billion, timely and effective intervention for persons with cord injuries who abuse or are at risk for alcohol abuse is both humane and cost effective.